‘By two weeks, your baby... should manage to last three to four hours between feeds.’ The New Little Contented Baby Book ‘The infant should be put to the breast at regular intervals of about four hours.’ Chambers Encyclopedia, 1880 ‘A baby that is latched on correctly will rarely need to spend more than an hour feeding.’ What to Expect When You’re Breastfeeding – And What if You Can’t? ‘If he were suckled at stated periods he would only look for it at those times, and be satisfied.’ Advice to a Wife and Mother, 1872. Your baby is very unlikely to have read any of these books. Feed your baby when he’s hungry, and feed him until he’s had enough. Some people call that ‘feeding on demand’. What a daft phrase. He’s not being demanding. He’s not trying to ‘manipulate’ you, or to ‘get you to react’. He’s tiny, he’s vulnerable and he has a stomach the size of a golf ball. He’s hungry. Feed him. What if he just wants comfort? So, comfort him! If he wants the breast, that’s fine. If your baby isn’t allowed some comfort in the first few months of his life, then when is he ever going to get some? Feeding hunger is the best way to establish successful breastfeeding. Your breasts work on a supply and demand basis. However much the baby suckles at one feed, that’s how much they ‘expect’ to make the next time round. Your breasts have to keep up with the needs of a growing infant. You are the sole life support system for a tiny, voracious person who is going to double his weight in a matter of months. That’s why when he’s hungry, you feed him. I found this one pretty simple. My baby settled into a pattern of wake up, feed, play, feed, sleep. I spent an incredible amount of time breastfeeding, which was fine, because I’m basically quite lazy. The baby got fat. Breastfeeding is a natural way for a baby to go to sleep. After all, your milk has delta-sleep-inducing-peptide in it. Sure, feeding my baby to sleep each time meant that he expected to go to sleep feeding a lot. That didn’t really bother me. I figured I was his mum, and I wasn’t going anywhere. It’s not that straightforward for everyone. Some babies get pretty crabby, the mother wonders what on earth she’s doing wrong, and may well feel subtly blamed by hippy earth mothers like me who float around saying ‘Oh, it’s easy – you just feed the baby lots’. Sometimes there is a medical cause for excessive crying, so get your baby seen by a doctor. An internet search for ‘colic’ or ‘reflux’ may help make sense of your baby’s symptoms. If she is suffering from colic, then cutting out dairy products from your diet may help (see page 81). Reflux is helped by frequent breastfeeds, and by being carried upright in a sling. Difficult babies, particularly if they have been through a difficult birth, often benefit from seeing a craniosacral therapist or chiropractor. Cranky babies are often over stimulated and overtired, and might benefit from quiet times where you have to help them to sleep. Tracy Hogg, (who I disagree with on some issues) advises in her book The Baby Whisperer that you institute a pattern of wake up, feed, play, sleep. It works for some babies, who will fall asleep calmly once you recognise their tired signs (yawning, turning away from toys) as long as you intervene before they become overtired. But hang on, Tracy Hogg is a nursery nurse: she’s very good at getting babies to sleep without breastfeeding, because that’s her job. Sure, some babies don’t need to be breastfed to sleep, and you can experiment with different sleep strategies to find the one that works for your child. But if your baby is crying and you know that the breast will calm him, bear in mind that maybe he’s right, and the books are wrong. Give yourself time and space to learn your baby. If he’s crying, he’s either hungry, or tired, or overtired, or freaked out, or in pain, or has wind. He’ll have different cries for different scenarios, except for hunger and wind which, confusingly, can sound exactly the same. An older baby will add an ‘I’m bored, play with me’ cry to his repertoire. Newborn babies don’t do this. Basically, the baby indicates ‘jump’ and you respond with ‘how high?’. That’s a psych-ologically healthy and appropriate relationship between a small baby and his carer. Exactly what you need to do when he says ‘jump’ is a voyage of discovery, although in my experience, it generally involved unhooking my bra. Breastmilk helps with more than just hunger. It eases pain, dilutes reflux, quenches thirst, fights infections, aids sleep and calms jangled nerves. If it’s not working for your baby, then try something else, but if it is then don’t knock it. Part of your job involves responding to your baby’s needs, the other part involves anticipating his needs. It can take weeks for you to both start to click in together. Sometimes he will be freaked out because you will be freaked out because it’s all too much. There will always be days when things don’t go right between you, although they’ll hopefully be balanced by days where they do. There is no such thing as a perfect mother. Chuck out the clock You’re doing a vital job when you spend all day just hanging out, trancing out with your baby. Psychologist Naomi Stadlen has written a brilliant book What Mothers Do, in which she lists all the things that mothers do with their babies that we don’t even have words for. So many mothers think that they ‘haven’t got anything done’ with their day, when they have, they’ve put their time in to make a whole new happy person. I can’t tell you how often to feed your baby because I don’t know how hungry your baby will be. But I do know that sitting there watching the clock is going to make breastfeeding a more frustrating experience. Babies don’t do very much when they feed. They pause, they flutter, they pause a while more. You can’t really hurry them up – you have to slow down to match. Sure, if you want to, you can note what time of day your baby likes to feed. If you are an organised person who likes some structure to the day then you can draw up all kinds of charts and tables showing when your baby likes to do what. Or you can drift along, taking each day as it comes. Either approach is fine. What isn’t OK is making a hungry baby wait to feed until some book says that a suitable time has elapsed. Remember, your baby hasn’t read those books. Did you think that your baby was only going to be hungry every four hours? I wonder where that idea came from? There has been a lot of absolute rubbish written about childcare over the last 200 years, most of it by men, and very little of it by mothers. The nineteenth and twentieth centuries saw great advances in medical science; amazing leaps in our understanding of such things as germs, disease transmission, anaesthesia and surgery. Unfortunately, this was accompanied by the medicalisation of babycare, which removed and distanced women from their babies. The idea, the doctors thought, was simple. A baby is a blank slate, in effect a little machine. If you programme it to feed every four hours, it will. If you ‘give in’ and allow it to ‘dictate’ its unreasonable demands, then you have made a rod for your own back, and you’ll be running after it day and night. Be firm, and teach that baby to be more reasonable. Stop that mollycoddling, and instill it with independence from an early age. This school of thought is still prevalent in popular attitudes to childcare today, and it’s based on a fundamental misunderstanding of human psychology. A baby’s needs are entirely unreasonable. He has no sense of time. He doesn’t know that in another twenty minutes, his food will be coming. All he has is HUNGRY and NOW. If you don’t pick up on his hungry face, and little hungry noises, then he has to do hungry CRYING, and that’s all he can do to get food. The doctors noted that when they prevented the mother from answering those cries, the baby eventually stopped bothering to make them. So their theory worked. When a mother only suckled an infant at stated periods he did learn not to cry when he was hungry. And he learned a very harsh lesson about life for one so young – that you can’t expect your basic needs to be met. Maybe the child somehow managed to be satisfied even when he was hungry. Or maybe, he was just deeply depressed. You can’t teach your baby to be reasonable. Reason is something he will learn much later, well after he has grasped such concepts as cause and effect. You also can’t teach your baby to be independent. Your child, as he grows older, will naturally become independent, all on his own, as he branches out and does new things, because he is happy, and contented and secure in your love. You can’t force independence, he has to choose it. Here’s an analogy. If you want to, you can choose solitude. You can sit in your bedroom and meditate for a week if that’s what floats your boat. However, if someone were to force solitude upon you, say, by installing a lock on the outside of your bedroom door, then that would no longer be solitude – it would be imprisonment. It’s just the same with child development; forced independence isn’t independence, it’s abandonment. And when you’re tiny and helpless, and your parents are your only means of surviving in this world, abandonment is very scary indeed. At the same time as strict, four-hourly feeding schedules started to be advocated, bottle-feeding became more popular. I wonder why? So it takes twenty minutes for a baby to digest breastmilk, but how long does it take for her to digest formula milk again? Oh yes, that’s right. Four hours. What a good baby, not crying between meals. Four hours is the maximum that a newborn baby should go without a feed, measured from the beginning of one feed to the next. And when a breastfeeding mother makes herself wait between feeds, her breasts get full, they get the message that they’re overproducing, so they scale down milk production. Although women and babies have survived breastfeeding regimes which space and limit feeds, optimum breastfeeding occurs when when she stays in closer contact with her baby’s dietary requirements. One modern version of the old-school strict baby routine attempts to address the problem of diminishing supply by getting mothers to express milk as well as breastfeeding. Routine for a breast-feeding baby at one week: 7am - Baby should be awake, nappy changed and feeding no later than 7am. - He needs 25-35 minutes on the full breast, then offer 10-15 minutes on the second breast after you have expressed 60-90ml. - Do not feed after 8am, as it will put baby off his next feed. The New Contented Little Baby Book You could do this. If you wanted to, you could rise at the crack of dawn and sterilise a bottle, assemble a breast pump while your child is crying, try to calm him on schedule, feed him a little (but not enough to get much high-calorie hind milk) and then put him down to scream while you attempt to express milk from your breast. Or you could stay in bed and feed your baby. Books that tell you when to do what to your baby are very popular. Partly this is because many women in modern society have no experience whatsoever of babies, before sud-denly being handed their own. It is reassuring to find that you can buy an instruction manual that tells you something more specific than ‘hey, man, just go with whatever your baby says he needs’ (basically, my position). But really, it’s because women today are doing an impossible job... Human beings are a tribal species. Just as surely as fish swim in shoals and wildebeest run in herds, we have evolved to live in a close-knit, extended family group. There is a common saying in many countries that ‘it takes a village to raise a child’, and if we were living as we were designed to live, at least twenty other people would be actively helping you and your partner to look after this baby. Ideally, you would have... Some older women to professionally swaddle your babe and carry her off when she has colic. A gang of children excitedly playing together. As soon as your toddler could walk, she would run off and join them. Some nine-year-old girls who would really love playing with your real-life baby doll, and who would take her away and amuse her for long periods. Children love babies, and babies love children. Your sister doing all the cooking and washing when you’re healing from the birth. Some blokes around to chop firewood and to inspire your sons to do huntin’, shootin’, fishin’ and manly things. Instead you have CBeebies, to entertain your toddler. Pizza delivery, for your emergency dinner needs. A buzzing rockatotta bouncing chair with plastic dangly bits, to amuse your baby. Internet chat rooms, to ask other experienced mothers what’s going on. The men away at work, or down the pub. Good thing you don’t need any chopped firewood. The problem with our modern way of life is that babies prefer human company to plastic, bouncing, rockatotta baby seats. This is why: Human evolution: scenario 1 Once upon a time, a baby was born who was quite happy to be left alone for long periods of time. He sat gurgling beneath a banyan tree... ...until a tiger came along and gobbled him up. Human evolution: scenario 2 Around the same time, another baby was born. Every time his mother tried to put him down, he screamed as if a tiger was about to attack him... Guess which baby yours is descended from? Human babies are extraordinarily needy. If our babies were as physiologically developed as say, a gazelle’s baby, then you would be giving birth to a walking, talking toddler who would be ready for preschool. But we are not gazelles. We walk upright, which means we have a smaller pelvic opening, and we have large brains, which makes for bigger heads. So we have to give birth to our babies when they are still very tiny, and developmentally still pretty helpless. For most of our evolutionary history, our babies have been carried by loving members of the tribe. Predators were a real risk. Constant carrying kept babies safe. It seems likely that the first clothes humans developed were baby slings, adopted to bind their babies to their hairless bodies. Mothers weren’t expected to care for their babies on their own. Human beings and whales are the only species to have a menopause. Every other kind of animal, including chimpanzees, remain fertile until the day they die. Those older, wiser, infertile grandmothers evolved to help us with our needy babies.1 So, your baby doesn’t know that she’s ‘meant’ to sleep alone in a cot. She doesn’t know that she really should like the fancy bouncy chair that you spent so much money on. Human contact feels good to her, and she’s going to want lots of it, because that is how babies have always survived. Assuming that you’re on your own with your baby for much of the day, your baby is likely to want you to hold her for much of the time. Unfortunately, unlike all the relatives and other village members who should be sharing this task, you smell lovely and milky. So, while you’re holding her, she might opportunistically remind you that she’d like a little snack. Therefore, you are likely to do a lot of breastfeeding, possibly more often than the mother with the extended network of impromptu babysitters. The way that our society is structured makes life difficult for mothers. Up until the late eighteenth century, family life, home life and work life in Britain were integrated. You worked alongside your children, and they grew up helping you with your tasks. This was still tribal living, with the flexibility for many different people to interact with, and be responsible for the baby over the course of the day. Then came industrialisation. Men went off to the offices and factories. Children were herded off to school. Women were left holding the baby. Throughout the nineteenth century, most women worked from home, and juggled domestic drudgery, childcare and piecework or laundry to supplement their income. In the late twentieth century, we won the right to go out to work with men on equal terms, and with a stab at equal pay. But this hasn’t actually made life any easier for the mothers of young babies. Back in the drearily tedious world of the 1950s housewife, women could at least depend on there being other mothers around nearby. Most neighbourhoods consisted of networks of women actively supporting each other in their endeavours. Nowadays, the vast majority of women work outside the home. This means that your identity and your social network is likely to be bound up with your job. Once you’ve left on maternity leave, you no longer see a whole swathe of people who are socially important for you. You probably don’t know your neighbours, or because they’re out at work all day, they aren’t around to help. You are likely to have moved away from your parents and sisters so you or your partner can find work. You’re on your own. That’s the problem. So what do women do to try and manage the impossible job of meeting their own and their babies’ needs alone? Strict babycare routines have been developed by nursery nurses and other childcare professionals to try and reduce a baby’s dependence on his carers. If you do exactly the same thing at exactly the same time each day, then the baby does expect sleeping and eating to only happen at these intervals. This theoretically gives the mother more time off, but it also ties her into a very rigid pattern for her days. The guesswork is taken out of parenting. You no longer have to respond to your baby’s cues, instead you simply anticipate everything your baby might need, before he has a chance to ask for it. These routines are designed to be implemented from the first week of a baby’s life. I’m sorry, but you could train a puppy to live in a box if you did it from the first week of its life. That doesn’t make it natural. If you do opt for a very structured parenting routine, and you want your breastfeeding to succeed (and, let’s face it, breastfeeding isn’t the be all and end all of motherhood, it’s just a healthy, lovely bit) then delay imposing feeding schedules until you have been feeding well for three months. But there are other ways of raising a baby. It cuts me up that there are mothers out there who feel they are failing, or that their baby is ‘difficult’ because he doesn’t feed or sleep at the times some book says he should. We’re all different, babies included. Because babycare routines are so popular, they dominate people’s ideas of how you are meant to bring up a baby. ‘What’s your routine?’ my sister was asked. ‘Er, my mum comes round on a Thursday.’ Plenty of babies survive just fine with very little in the way of a structured routine. Some need nap times, others just fall asleep on the breast. If you have one of those babies who is happy to be hoicked around with you in a sling all day, then you can start to discover some of the advantages of not following a routine with your baby. I drove a camper van across Spain with my son when he was six months old, and we had a brilliant time. Routine? What routine? When do I next feed my baby? At the next lay-by! My baby slept happily through Spanish fiestas. I could never count on my son going down in his cot for a set amount of time, while I got on with other things. Instead, he was pretty much always in close contact with me or his dad. It was like there was still an umbilical cord there connecting us. And I really liked it like that. I breastfed him and we carried him and slept with him a lot. It was straightforward, and worked very well for me. When I wanted a break, I recreated those old tribal networks and found a friend to take him for a bit. Many men, in particular, have never had a chance to hold a baby. They won’t volunteer to take yours out of an understandable fear that its wobbly, squashy head might fall off. However, if you plonk the baby on them and explain the basic way to hold it, they can have some lovely baby time, and you can have some lovely not-baby time. Spontaneous parenting depends on you being more available for your baby than structured parenting, but it brings its own rewards. When you’re breastfeeding easily, and carrying your baby around with you, and if you don’t bother faffing around with breastpumps and bottles and blackout blinds and cots, then you’re a very portable package. So you and your baby can go out and have more fun. However much structure you and your baby need, the key thing is to be responsive to your baby. The good news is that, contrary to popular belief, responsive parenting actually makes your job easier. The childcare ‘experts’ told women that if they rushed to pick up their babies, they would learn to cry more. Rubbish. That’s the exact opposite of what actually, initially happens. If a mother consistently fails to pick up on a baby’s subtle, non-verbal cues, and waits until her baby has been crying for some time before she attends to him, then the baby learns to cry more, and louder, any time he has a need that must be met. Feeling hungry? Don’t waste time hanging around frowning and eating the blanket, no SCREAM – NOW AND FOR AGES – that’s how you get fed. If turning away from that unpleasantly bright sunshine doesn’t work then accompany it with a very loud SCREAM. Straight away. You can see this in a study2 that compared mothers of young babies in London and in Copenhagen in 2006. The British mothers tended to respond slowly to their babies. They delayed going to their crying child about forty per cent of the time and the distressed babies were left without contact for up to an hour a day. The Danish mothers promptly answered their babies’ cries, and the total amount of time the babies were left to cry without being held was only about 15 minutes in every 24 hours. By the time they were just ten days old, the British babies in the survey had learned to cry more. Fifty per cent more. That’s a lot. And the British mothers still had to spend just as much time feeding and caring for their babies, so that crying was completely pointless. The effects lasted. Their babies still cried more at five weeks and at 12 weeks of age. The study only followed the babies up to the age of 12 weeks. Presumably, some of these babies might have gone on to learn that there’s no point in screaming, and stopped. But I hope not. Responsive parenting is the key to having happy children. If you regard a child’s needs as unreasonable demands that should be ignored, then that will mess them up emotionally in one of two ways. Your child could learn to exaggerate their needs to get your attention. Here lies the paradox that people who try and train their children to be independent before they are ready end up with really whiny, clingy kids. Alternatively your child could learn to swallow his needs, and never to express them. This results in a kind of emotional detachment, where he can never really be in touch with his feelings, because deep down, he knows that it is unacceptable to have any. Does this sound extreme? It has been scientifically verified in laboratory tests. Attachment theory 3 Mary Ainsworth, a developmental psych-ologist, spent a lot of time in the 1960s studying pairs of mothers and babies in Africa and in the US. What she was studying was the quality of the bond between the two, and she paid particular attention to how responsive a mother was to her baby’s cues. From this, she developed the Strange Situation Test. An eleven-month-old baby was briefly left with a stranger in a laboratory, and then his reaction was studied when he was reunited with his mother. The Strange Situation Test can be used to divide mother/baby pairs into three broad categories of bond or ‘attachment’. Some of the babies were upset when their mother left the room, but when she came back, they accepted comfort from her and quietened down quickly. These babies had mothers who were prompt, consistent and appropriate in their attentions. They could trust their mothers to meet their needs. They played happily. They were ‘secur-ely attached’. The other babies, the ‘insecurely attached’ ones, reacted in two different ways. Some babies were incredibly distressed when their mother left the room, and when she returned they were angry with her and slow to start playing again. They had mothers who sometimes come to them promptly, but at other times, for whatever reason, just couldn’t sort them out, so they were always anxious about whether she was going to be able to meet their needs. Their negative emotions were exaggerated. They were ‘ambivalently attached’. And the third group were really worrying. These ‘avoidantly attached’ babies showed little or no emotion when their mother left them. There was no response when she came back either. That level of independence at such a young age is just not good. These babies had learned that their mothers were not around to meet their emotional needs, so they just stopped displaying any. But those feelings were still in there, bubbling away. They couldn’t explore and play as well as the other children. The effort of controlling their emotions didn’t leave them much energy for learning. Generations of social scientists have had the opportunity to study what happens next to insecurely attached infants. At preschool, the securely attached children turned out to be happy, fun, sociable, popular and intelligent. The anxiously attached kids acted babyish for their age – their extreme mood swings often interfered with their ability to learn. The avoidantly attached children bullied others at school – unable to access their own unhappy feelings, they felt no empathy for the hurt of others. These children were not being abused. (There is a fourth category, ‘disorganised attachment’ for babies who are actually scared of their carers.) The mothers in all three groups were meeting their children’s needs for food and shelter. Most of the mothers were affectionate, and few were overtly hostile. All these mothers loved their children. They all held their children for about the same amount of time overall. However, there was one big qualitative difference in what they did when they picked their babies up. The mothers of the insecurely attached babies never picked their babies up when the babies signalled that they wanted to be held. More than a third of babies in the UK and in the US can be classed as insecurely attached.4 These babies grow up to be adults who have problems with work, with relationships, and with their mental health. As a society, we are massively failing to raise emotionally well-adjusted children. And still mothers here are isolated, unsupported, and encouraged to ignore their hungry babies for hours at a time. You have nothing to lose, and everything to gain by being as responsive to your baby as you can. Try to keep the attitude that it’s OK, your baby is OK, he’s allowed to cry and be demanding, and yes, it’s difficult, but that’s not your baby’s fault. Take support where you can. Don’t be afraid to ask for help. It’s normal to think that because it’s so hard, then you must be doing something wrong. But babies are also amazing and wonderful, and they don’t stay babies for long. You can experiment with ways to make it easier for you too. You’ll probably have to at some point – if not with your first child then certainly with your second. Check that your attachment and positioning is good. A baby that is latched on well is feeding most efficiently. Sometimes you can feel the ‘draw’ as milk is drained from the breast at the beginning of a feed. Offer both breasts at each feed to let her fill herself up as much as she can in one go. Try breast compression (page 71) if you’re irritated by her feeding slowly. If you still feel that your baby is feeding excessively, get your breastfeeding evaluated by a specialist. She will be able to offer you practical advice tailored to your situation. Once your breastfeeding is established, it becomes more flexible. If you spend three months feeding your baby lots, then your milk won’t dry up if you introduce the odd bottle of formula. (There’s more about mixed feeding on page 180). Try expressing milk so someone else can feed her if you want to experience the giddy feeling of lightness you get when you leave the house alone (see page 161). Both these strategies make breastfeeding easier for some mothers. Other women find exclusive breastfeeding easier, because they don’t have to sterilise anything. Your milk supply will work best if you feed your baby until she finishes her feed herself. However, this isn’t always practically possible. Start off with this policy and find out for yourself how much breastfeeding your baby is capable of! Then once you are confident about the dynamics of breastfeeding and can see that she’s gaining weight, you can experiment with cutting feeds short. One way to gauge this is to look at her little arms. She might start the feed with them all scrunched up, holding or sometimes pummelling the breast (which actually massages it and increases the milk flow – clever thing!). Then she’ll settle down to the long business of obtaining nutrition. Her arms will gradually lose their tension, and start to drift away from your breast. Once they’re down by her sides, you can assume she’s pretty much done. Switch her to the other breast if she wants it – if not, hooray! put her down and creep away... It’s still a good idea to let her finish some feeds herself. Particularly if there’s something good on telly. How often should you feed your baby? A lot. You can’t over feed a breastfed baby. She can be as fat as a piglet and still be totally and utterly, completely healthy. ‘Strue.
